Dava Dilekçesi (Vergi Mahkemesi'ne)

                                        (...)Vergi Mahkemesi Başkanlığı'na

                                                                            Duruşma ve Yürütmenin Durdurulması İstemlidir.

                                                                                                                    (Varsa)

Davacı........................................................:(İsim-Soyadı, adres ve mükellef no)

Vekili (Varsa).............................................:(İsim-Soyadı, adresi)

Davalı.........................................................:(Davalı idare veya idarenin adı adresi)

Davanın Konusu.........................................:......................................................................

Vergi ve Cezanın Nevi.................................:......................................................................

Yılı................................................................:......................................................................

Miktarı........................................................:......................................................................

Dava Konusu İşlemin Tebliğ Tarihi...........:......................................................................

Maddi Olay..................................................:.......................................................................

Hukuki Dayanak ve Deliller......................:.......................................................................

............................................................................................................................................

............................................................................................................................................

Sonuç ve Talep..........................................:...........................................................................
Ekler  :

1............................                                                                        İsim-Soyadı

2...........................                                                                             (İmza)

3............................